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Robotic assisted simple prostatectomy: recent advances.
Curr Opin Urol. 2018 05; 28(3):309-314.CO

Abstract

PURPOSE OF REVIEW

Robotic assisted simple prostatectomy (RASP) represents a minimally invasive evolution of traditional open simple prostatectomy for the surgical treatment of severe lower urinary tract symptoms (LUTS) because of benign prostatic enlargement (BPE). Aim of the present review is to summarize the most recent evidence on this novel procedure, and to better define its current role in the surgical armamentarium for the treatment of BPE.

RECENT FINDINGS

Several studies demonstrated that RASP can be safely and effectively performed in centers with sufficient expertise. The procedure can duplicate its open counterpart with the advantage of lower perioperative morbidity, and ultimately faster patient recovery. Overall, the status of RASP seems to be well beyond that of an 'investigational' procedure, and guidelines should be amended accordingly.Nevertheless, it remains to be determined what the place of the RASP procedure in the surgical armamentarium for the treatment of symptomatic BPE will be. Over the most recent years, few comparative studies have been reported, allowing in part to draw some conclusions. RASP seems to be attractive when compared with open simple prostatectomy as it can offer less blood loss, and shorter hospital stay. However, its advantages over transurethral enucleation techniques - such as HoLEP - remain unclear. There are some specific indications, such as the presence of concomitant bladder diverticula or stones, for example, where a robotic approach could represent an appealing solution. Ultimately, further research should look at a cost analysis to determine which technique can be more cost effective. Last, the issue of the learning curve for the different procedures for symptomatic BPE remain to be further scrutinized.

SUMMARY

RASP offers potential advantages over other available techniques for the treatment of large prostate glands. In centers, wherever a solid robotic program is already in place, this procedure is likely to be increasingly implemented.

Authors+Show Affiliations

Division of Urology, Virginia Commonwealth University. Division of Urology, McGuire VA Medical Center, Richmond, Virginia, USA.Division of Urology, Virginia Commonwealth University. Division of Urology, McGuire VA Medical Center, Richmond, Virginia, USA.Department of Urology, Medical University of Vienna, Austria. Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania.Department of Urology, Medical University of Vienna, Austria. University of Texas Southwestern Medical Center, Dallas, Texas. Department of Urology, Weill Cornell Medical College, New York, New York, USA.Department of Urology, San Luigi Hospital, University of Turin, Orbassano, Italy.Division of Urology, Virginia Commonwealth University. Division of Urology, McGuire VA Medical Center, Richmond, Virginia, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29528970

Citation

Vince, Randy, et al. "Robotic Assisted Simple Prostatectomy: Recent Advances." Current Opinion in Urology, vol. 28, no. 3, 2018, pp. 309-314.
Vince R, Hampton LJ, Vartolomei MD, et al. Robotic assisted simple prostatectomy: recent advances. Curr Opin Urol. 2018;28(3):309-314.
Vince, R., Hampton, L. J., Vartolomei, M. D., Shariat, S. F., Porpiglia, F., & Autorino, R. (2018). Robotic assisted simple prostatectomy: recent advances. Current Opinion in Urology, 28(3), 309-314. https://doi.org/10.1097/MOU.0000000000000499
Vince R, et al. Robotic Assisted Simple Prostatectomy: Recent Advances. Curr Opin Urol. 2018;28(3):309-314. PubMed PMID: 29528970.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Robotic assisted simple prostatectomy: recent advances. AU - Vince,Randy, AU - Hampton,Lance J, AU - Vartolomei,Mihai D, AU - Shariat,Shahrokh F, AU - Porpiglia,Francesco, AU - Autorino,Riccardo, PY - 2018/3/13/pubmed PY - 2019/8/9/medline PY - 2018/3/13/entrez SP - 309 EP - 314 JF - Current opinion in urology JO - Curr Opin Urol VL - 28 IS - 3 N2 - PURPOSE OF REVIEW: Robotic assisted simple prostatectomy (RASP) represents a minimally invasive evolution of traditional open simple prostatectomy for the surgical treatment of severe lower urinary tract symptoms (LUTS) because of benign prostatic enlargement (BPE). Aim of the present review is to summarize the most recent evidence on this novel procedure, and to better define its current role in the surgical armamentarium for the treatment of BPE. RECENT FINDINGS: Several studies demonstrated that RASP can be safely and effectively performed in centers with sufficient expertise. The procedure can duplicate its open counterpart with the advantage of lower perioperative morbidity, and ultimately faster patient recovery. Overall, the status of RASP seems to be well beyond that of an 'investigational' procedure, and guidelines should be amended accordingly.Nevertheless, it remains to be determined what the place of the RASP procedure in the surgical armamentarium for the treatment of symptomatic BPE will be. Over the most recent years, few comparative studies have been reported, allowing in part to draw some conclusions. RASP seems to be attractive when compared with open simple prostatectomy as it can offer less blood loss, and shorter hospital stay. However, its advantages over transurethral enucleation techniques - such as HoLEP - remain unclear. There are some specific indications, such as the presence of concomitant bladder diverticula or stones, for example, where a robotic approach could represent an appealing solution. Ultimately, further research should look at a cost analysis to determine which technique can be more cost effective. Last, the issue of the learning curve for the different procedures for symptomatic BPE remain to be further scrutinized. SUMMARY: RASP offers potential advantages over other available techniques for the treatment of large prostate glands. In centers, wherever a solid robotic program is already in place, this procedure is likely to be increasingly implemented. SN - 1473-6586 UR - https://www.unboundmedicine.com/medline/citation/29528970/Robotic_assisted_simple_prostatectomy:_recent_advances_ L2 - http://dx.doi.org/10.1097/MOU.0000000000000499 DB - PRIME DP - Unbound Medicine ER -